神经肌肉疾病患者无创通气撤机失败后成功拔管：病例系列
Successful Extubation After Weaning Failure by Noninvasive Ventilation in Patients With Neuromuscular Disease: Case Series.
作者信息
Kim Sun Mi, Kang Seong-Woong, Choi Young-Chul, Park Yoon Ghil, Won Yu Hui
机构信息
Department of Medicine, Graduate School of Yonsei University, Seoul, Korea.
Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea.
出版信息
Ann Rehabil Med. 2017 Jun;41(3):450-455. doi: 10.5535/arm.2017.41.3.450. Epub 2017 Jun 29.
OBJECTIVE
To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation.
METHODS
Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO (ETCO) and pulse oxyhemoglobin saturation (SpO) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days.
RESULTS
A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive.
CONCLUSION
NIV may promote successful weaning in neuromuscular patients with experience of reintubation.
目的
报告我院在有再插管经历的神经肌肉疾病患者中，使用包括无创通气（NIV）在内的肺康复治疗实现有创机械通气撤机的成功案例。
方法
回顾性研究那些通过传统撤机策略撤机失败，但随后通过无创通气成功撤机的患者。持续监测呼气末二氧化碳（ETCO）和脉搏血氧饱和度（SpO）。撤机成功定义为在至少5天的时间内不需要通过气管插管或气管切开进行有创机械通气的状态。
结果
共有18例最初撤机失败的呼吸衰竭患者在撤机后最终接受了部分时间的无创通气。没有患者因无创通气出现任何严重或长期的不良反应，所有患者均存活出院。
结论
无创通气可能促进有再插管经历的神经肌肉疾病患者成功撤机。
Zotero 插件